Dr Angel Dillip is a social scientist and epidemiologist who has extensive experience in public health research. She works for the Ifakara Health Institute in Tanzania and has an interest in grassroots development interventions.
Along with Dr Sally Mtenga, Angel facilitated three arts-based workshops in Bagamoyo that took place in February and May.
Angel said: “Type 2 diabetes [T2D] is a major issue in Bagamoyo. When we sought out people to take part in our workshops, we worked with the ward executive officers and all of them mentioned diabetes as a health concern in the area. This came up time and time again.
“Our creative workshops backed this up—with both the men and women’s groups agreeing T2D was the non-communicable disease they wanted to focus on. They debated between diabetes and hypertension , but all participants came to an agreement that diabetes was more problematic, which was why they chose it.”
Angel and Sally heard from plenty of people who had personal experience of T2D through relatives or neighbours, and many of them had a good understanding what the condition entailed. Many people knew, for example, that being overweight was a risk factor for T2D.
DIABETES IN TANZANIA
There were 897.000 cases of diabetes in Tanzania in 2017. Total adult population : 25,039,000. Prevalence of diabetes in adults : 3.6% Total cases of diabetes in adults : 897,000. 2% of all deaths*
Verbalised senses activity
“What I found most interesting,” Angel added, “was the verbalised senses exercise we did with participants, where they described sight, sound, touch, taste and smell and how they are related to the condition.
“People described T2D as looking like a snake that goes through your body. The snake bites you and the poison once you get it is very dangerous, more so even than HIV if you can’t control it properly.
Angel added: “What we wanted our participants to do was come up with an arts activity they thought could best explain T2D—that could include anything from a poem to a play. The activity was to be used to explain what can cause T2D, risk factors and what its consequences can be.
“Our different groups focussed on activities such as a poem which described the impact of diabetes where the disease isn’t treated properly, and the risks such as amputations.
“Another group came up with a drama which they performed. In this, a son spoke to his father about diabetes, trying to persuade him to reduce the amount of sugary drinks he [the father] drank.
“I found the group’s activities very interesting to watch.”
Angel enjoyed the final workshop—where men and women came together to discuss what had happened at the previous workshops, the interventions they had come up with and what they thought would be the most effective activity.
Angel and Sally also used the opportunity to work with the participants on their understanding of diabetes, its causes and the measures you can take to prevent it. They also had the chance to address any misunderstandings.
During the final workshop, the facilitators divided the participants up into three groups, asking them to come up with an intervention activity based on the risk factors for diabetes and what can be done to address each of those risks.
The first group opted to emphasise the important of regular exercise. The second group zoned in on the eating smaller meals. In Tanzania, there is a tendency for people to help themselves to big portions of rice with their meals.
The third group wanted an intervention that had highlighted the over-consumption of sugary drinks.
Angel continued: “We told the three groups to come up with different ways to communicate their messages. Our first group wanted to use posters. The second group weren’t quite as sure what to use for their message of eating smaller meals, but thought story-telling posters might work, while the third group wanted to use drama.”
“We are currently analysing the data we got back from all the workshops and working with a local arts teacher to help the participants develop their intervention activities—how they spread the message and making their activities more focussed. We’ll buy any equipment the groups need and look at other ways to publicise what we are doing—T-shirts perhaps?”
The intervention activities are to take place in the first week in July. Participants identified the market place as the best venue for performances/activities as a lot of people come to the market.
Angel is looking forward to seeing what the participants come up with. “Ultimately, we want our intervention activities to encourage people to change their behaviour, so they can reduce their risk of being diagnosed with T2D.”